IRCCS Mondino Foundation, Pavia, Italy.
Dept. of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.
Aging Clin Exp Res. 2021 Jun;33(6):1567-1575. doi: 10.1007/s40520-020-01665-2. Epub 2020 Sep 8.
BACKGROUND: The effectiveness of computer-based cognitive training (CCT) remains controversial, especially in older adults with neurodegenerative diseases. AIMS: To evaluate the efficacy of CCT in patients with Parkinson's disease and mild cognitive impairment (PD-MCI). METHODS: In this randomized controlled trial, 53 patients were randomized to receive CCT delivered by means of CoRe software, traditional paper-and-pencil cognitive training (PCT), or an unstructured activity intervention (CG). In each group, the intervention lasted 3 consecutive weeks (4 individual face-to-face sessions/week). Neuropsychological assessment was administered at baseline (T0) and post-intervention (T1). Outcome measures at T0 and T1 were compared within and between groups. The Montreal Overall Cognitive Assessment (MoCA) was taken as the primary outcome measure. RESULTS: Unlike the PCT group and the CG, the patients receiving CCT showed significant medium/large effect size improvements in MoCA performance, global cognition, executive functions, and attention/processing speed. No baseline individual/demographic variables were associated with greater gains from the intervention, although a negative correlation with baseline MoCA performance was found. CONCLUSION: CCT proved effective in PD-MCI patients when compared with traditional PCT. Further follow-up assessments are being conducted to verify the retention of the gains and the potential ability of the tool to delay conversion to PD-dementia. Trial registration number (ClinicalTrials.gov): NCT04111640 (30th September 2019).
背景:基于计算机的认知训练(CCT)的有效性仍存在争议,尤其是在患有神经退行性疾病的老年人中。
目的:评估 CCT 在帕金森病和轻度认知障碍(PD-MCI)患者中的疗效。
方法:在这项随机对照试验中,53 名患者被随机分为接受 CoRe 软件的 CCT、传统纸笔认知训练(PCT)或无结构活动干预(CG)。在每组中,干预持续 3 周(每周 4 次个体面对面会议)。在基线(T0)和干预后(T1)进行神经心理学评估。在 T0 和 T1 时比较组内和组间的结果测量值。蒙特利尔总体认知评估(MoCA)被用作主要结局测量指标。
结果:与 PCT 组和 CG 不同,接受 CCT 的患者在 MoCA 表现、整体认知、执行功能和注意力/处理速度方面表现出显著的中/大效应量改善。基线个体/人口统计学变量与干预后的更大收益无关,但与基线 MoCA 表现呈负相关。
结论:与传统的 PCT 相比,CCT 在 PD-MCI 患者中被证明是有效的。正在进行进一步的随访评估,以验证收益的保留和该工具延迟向 PD-痴呆转化的潜力。试验注册号(ClinicalTrials.gov):NCT04111640(2019 年 9 月 30 日)。
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